Preemptive surgery helps some cancer-prone women

NEW YORK (Reuters Health) – Women with a genetic mutation
that gives rise to colorectal cancer — a condition called the
Lynch syndrome — are also at high risk for endometrial and
ovarian cancer. Investigators now report that preventive
hysterectomy and removal of the ovaries is effective in
preventing these gynecologic cancers in such cases.

Dr. Karen H. Lu, from University of Texas M. D. Anderson
Cancer Center in Houston, and her associates report the
findings in the New England Journal of Medicine for January
19th.

In 1997, experts concluded there was insufficient evidence
to recommend preemptive gynecologic surgery for women with
Lynch syndrome.

To re-assess this option, Lu’s group evaluated outcomes
among women with the genetic mutation. The study included 61
women who underwent prophylactic hysterectomy matched with 210
controls of similar age, and 47 women who underwent
prophylactic ovary removal and 223 controls.

There were no cases of endometrial cancer among women who
underwent hysterectomy, and 69 in the comparison group.
Similarly, there were no cases of ovarian cancer among women
who underwent ovary removal versus 12 cases among the
“controls.”

These findings support consideration of preemptive
hysterectomy and ovary removal for women with the Lynch
syndrome “once childbearing has been completed,” Lu’s group
advises.

However, they add, “Patients should be advised of the
trade-offs between the reduction in the risk of cancer and the
risks and side effects of surgery.”

SOURCE: New England Journal of Medicine, January 19, 2006.